Objective: To explore the role of fibular internal fixation in surgical treatment of distal tibia and fibula fractures in children. Methods: We retrospectively reviewed 60 children with elastic stable intramedullary nailing for distal tibia and fibula fractures. The children were aged from 5 to 13 years. They were divided into group 1（28 cases with internal fixation of both the tibia and fibula） and group 2（32 cases with internal fixation of the tibia but not fibula）. Time to fracture healing

complications

and the postoperative function of fractured limbs（evaluated by Tornetta’s ankle function scoring） were compared between the two groups. Results: There were no significant differences between the two groups in terms of time to fracture healing

the incidence of complications

and ankle function score（P > 0.05）. Conclusion: Compared with fixation of only the tibia

fixation of both the tibia and fibula may reduce the incidence of complications in elastic stable intramedullary nailing for distal tibia and fibula fractures in children.